How To Improve Healthcare Revenue Cycle Management

The competitive landscape is fast changing and the healthcare industry is interestingly poised for smart automation. Already, paperless environment with the assistance of state of the art billing software has made it easy for streamlining the revenue cycle management process. However, resources are the key and a team that understands the real-time needs of the industry at present will be serving the right value.

Medical coding is an important asset to any medical claims. ICD-10 standards have made it a mandate for providers to implement sound strategies that are based on transparency. Elimination of malpractices especially down coding and up coding will be a key step that every practice will need to ensure.

Also, a pool of medical coders that provide the needed momentum and help in optimizing the value of claims with a proper description of the medical procedure observed will help in improved denial management.

Account management and an end to end support in collections will be an important aspect that every provider will need assistance. However, a perfect balance of current accounts, as well as aging accounts, has to be maintained that will bring consistency in the financial reimbursements.

Persistence, understanding the true value of each account by conducting a disciplined AR analysis and finally, a robust team in collections will be serving immense value in the longer run.

Another important factor will be to lay down the right checks and balances with precise practice management. Prior authorization and eligibility verification that is result driven will surely help a provider derive the right value.

Reducing time in first time prior authorization requests, following the required approval process with a dedicated understanding of the claims adjudication process is crucial. At the end, flexibility and a proven vendor in medical billing that will serve as the perfect operational extension will give an impetus to financial ROI of the healthcare providers.

Author Bio: Dr. Dipak Nandi MD is an active member of the United States-India Business Council (USIBC) and is involved in strategic initiatives with knowledge process outsourcing. A healthcare industry thought leader and seasoned entrepreneur; he is also a well-known psychiatrist. He has been instrumental over the years for major developments in medical billing outsourcing, telemedicine, and insurance claims adjudication.